Managing aging accounts receivable (AR) in healthcare can be daunting, affecting your cash flow and tying up crucial capital. AI and automation are revolutionizing AR management, making it more efficient and cost-effective. In a recent podcast, Bimal Sahoo, Principal Product Manager at Infinx, shared how these technologies can predict recoverability, prioritize aged accounts, and streamline processes.

AI and Automation in AR Management

Aging AR plagues many healthcare organizations, reducing cash flow and diverting resources. Traditional methods often lead to increased write-offs and operational costs. AI and automation offer innovative solutions, transforming AR management by enhancing predictive capabilities, automating prioritization, and streamlining processes.

Key Benefits of AI and Automation in AR Management:

  • Enhanced Predictions: Accurately forecast AR recoverability
  • Automated Prioritization: Efficiently handle aged accounts
  • Streamlined Processes: Accelerate claim status checks and other workflows
  • Cost Reduction: Lower operational expenses and improve cash flow

Predicting AR Recoverability: How AI Models Work

AI excels at predicting the recoverability of your AR accounts. By analyzing historical reimbursement patterns and payer behaviors, machine learning models provide powerful insights into which accounts are most likely to be recovered.

Factors Considered by AI Models:

  • Payer Information: Contractual amounts and payer details
  • Patient Demographics: Historical reimbursement data and demographics
  • Claim Details: Specific CPT and diagnosis codes
  • Inpatient Information: Length of stay and discharge disposition

These models identify granular patterns, allowing you to focus on high-recovery accounts, optimizing your efforts.

Automating Claim Status Checks and Other Processes

Automation significantly reduces the manual workload in AR management. Bimal emphasized the importance of automating claim status checks, which deliver real-time updates and minimize the need for manual follow-ups.

Benefits of Automated Claim Status Checks:

  • Real-Time Updates: Get instant status on claims
  • Reduced Manual Work: Minimize the need for intervention
  • Faster Resolutions: Quickly resolve outstanding claims
  • Increased Efficiency: Streamline your AR management process

Automation also enhances other processes, including appeals, eligibility checks, and insurance discovery, further boosting efficiency.

Case Studies: Success Stories from Infinx Clients

Bimal shared success stories from Infinx clients who have adopted AI and automation. These clients experienced remarkable improvements in financial performance and operational efficiency.

Impact of AI and Automation:

  • Improved Collections: Increase net collections by 15-20%
  • Reduced Days in AR: Decrease days over 90 and 120 by 20-30%
  • Lower Collection Costs: Reduce manual workload, lowering costs
  • Enhanced Cash Flow: Improve financial health and cash flow

Conclusion and Future Trends

AI and automation are transforming AR management, addressing the persistent challenges of aging AR. By predicting recoverability, automating claim status checks, and optimizing workflows, these technologies enhance efficiency and reduce costs.

Future Trends to Watch:

  • Advancing AI: Expect continued improvements in AI and machine learning for AR management
  • Integrated Solutions: Look for more sophisticated workflow and workforce management solutions
  • Widespread Adoption: Anticipate increased use of automation in various areas of revenue cycle management

As Bimal Sahoo emphasized, these technologies “never sleep,” offering continuous and reliable support for managing your accounts receivable. By leveraging these tools, you can maintain financial health and focus on delivering exceptional patient care.

Could your organization benefit from AI and automation in AR management? Book a free Quick RCM Health Check from our expert advisors. We’ll provide insights into the financial health of your organization to see if automation makes sense for you.

About Bimal Sahoo

Bimal Sahoo is a seasoned expert in the field of healthcare revenue cycle management, bringing over a decade of experience to his role as Senior Product Manager at Infinx. With a deep understanding of the intricacies of RCM and a passion for leveraging technology to solve complex problems, Bimal has been instrumental in developing and refining Infinx’s Accounts Receivable (A/R) and Denials Management solutions. His insights, drawn from extensive industry knowledge and practical experience, offer valuable guidance for providers seeking to optimize their denial management processes and improve financial outcomes.